Critical Care Newsline — June 3, 2010

Critical Care Newsline, the electronic newsletter from the American Association of Critical-Care Nurses, contains information selected just for you by our clinical practice experts. In each issue, you’ll find links to resources, research abstracts (individual sites may require registration and a fee to access complete articles) and websites that will keep you informed on issues affecting nurses and the nursing profession.

1. CALL TO ACTION Submit evaluation forms for CNE and CERP credit by June 7, 8 a.m.If you attended this year’s National Teaching Institute & Critical Care Exposition, Washington, D.C., May 15-20, submit evaluation forms online for CNE and CERP credit by Monday, June 7, 8 a.m. Pacific Time. After that, the certificates will be available for print only. Submit your forms online.

2. CALL TO ACTION Call for NTI 2011 abstracts extended to Monday, June 7, 11:59 p.m.AACN has extended the deadline for live education abstracts for the 2011 National Teaching Institute & Critical Care Exposition (NTI) in Chicago to Monday, June 7, 2010, 11:59 p.m. PDT. Access guidelines and get started.

3. EVIDENCENEJM study supports CPAP over intubation and surfactant in preterm infantsA randomized, multi-center trial, reported in The New England Journal of Medicine, May 17, supports continuous positive airway pressure (CPAP) instead of intubation and surfactant to treat preterm infants. Compared to infants who received surfactant, those on CPAP required less frequent intubation or postnatal corticosteroids for bronchopulmonary dysplasia and fewer days of mechanical ventilation. They were also “more likely to be alive and free from the need for mechanical ventilation by day 7,” states “Early CPAP versus Surfactant in Extremely Preterm Infants.”

5. CALL TO ACTION Share your thoughts, help AACN’s quest for excellenceThis year’s Annual Membership Forum at the National Teaching Institute & Critical Care Exposition, Washington, D.C., May 15-20, joined attendees with board members for focused discussions about AACN that explored answers to three questions: 1) What is the most innovative practice you’ve seen recently? 2) What can we, the AACN community, do to spread the word about these best practices to let other nurses know about them? 3) As a nurse, what gives you the greatest cause for optimism in the current environment? Respond to these questions at info@aacn.org or NTI Voices Online.

6. EVIDENCE Emergent ET intubations in children commonly increase complications “Emergent endotracheal intubations are commonly performed in children, are two times more likely to occur off-hours, and are associated with three times the risk of complications as nonemergent intubations,” states “Emergent Endotracheal Intubations in Children: Be Careful If It’s Late When You Intubate,” a retrospective cohort study in May’s Pediatric Critical Care Medicine.

8. EVIDENCE Target ranges of oxygen saturation in extremely preterm infants A randomized trial in The New England Journal of Medicine, May 16, found “a lower target range of oxygenation (85 to 89 percent), as compared with a higher range (91 to 95 percent), did not significantly decrease the composite outcome of severe retinopathy or death.” The abstract for “Target Ranges of Oxygen Saturation in Extremely Preterm Infants” adds the lower target range “resulted in an increase in mortality and a substantial decrease in severe retinopathy among survivors” — a major concern “since a lower target range of oxygen saturation is increasingly being advocated to prevent retinopathy of prematurity.”

9. CALL TO ACTION Participate in survey of hand-offs between CRNAs and SICU nursesNurses in the nurse anesthesia program at Georgetown University, Washington, D.C., ask nurses with surgical intensive care unit (SICU) or combined medical and surgical ICU experience to participate in a short survey about the hand-off process between certified registered nurse anesthetists (CRNAs) and SICU nurses. The deadline is June 4.

10. CALL TO ACTION Premier Safety Institute launches survey of injection practicesA short survey from Premier Safety Institute, Washington, D.C., helps identify the practices of clinicians who prepare or administer parenteral and injectable medications. Aggregate results will be shared with the Centers for Disease Control and Prevention, Atlanta, the U.S. Food and Drug Administration, Silver Spring, Md., and professional groups to guide research, outreach and education related to reducing risks to patients. The deadline to participate is June 18.

12. CLINICAL PRACTICE RESOURCESPatient SafetyOn May 31, a U.S. Food and Drug Administration (FDA), Silver Spring, Md., public health alert warned healthcare professionals not to use certain IV bags of metronidazole, ondansetron and ciprofloxacin because of possible contamination. The alert affects bags sold under the Claris, Sagent Pharmaceuticals, Pfizer and West-Ward Pharmaceuticals labels.

On May 26, the FDA reported that Baxter International Inc., Deerfield, Ill., voluntarily recalled all lots of Hylenex recombinant (hyaluronidase human injection) because of particulate matter in some vials during routine testing.

EvidencePreclinical studies show that induced hypothermia (IH) may save the lives of those with penetrating trauma with cardiac arrest, states “Induced Hypothermia for Trauma: Current Research and Practice,” published online May 18 by the Journal of Intensive Care Medicine. “However, its potential as a treatment in trauma is not as well defined,” notes the review article, which discusses potential benefits and complications of IH and emphasizes the “current state of knowledge and practice in various types of trauma.”

On May 7, the National Association of Nurse Practitioners in Women’s Health (NPWH) launched Estrogen Therapy I.Q. (ETIQ) — a campaign designed to provide credible information about menopause and estrogen therapy to women. ETIQ, supported by Upsher-Smith Laboratories, Inc., Maple Grove, Minn., grew out of an NPWH survey that found 78 percent of NPs thought their patients were “unaware of the variety of estrogen options available,” according to campaign information.

E-LearningAACN offers individual nurses access to two of its most popular Web-based courses, “The Preceptor Challenge” and double-award-winning “Promoting Excellence in Palliative & End-of-Life Care.” Nurses may purchase six-month access to “The Preceptor Challenge” for $100 and “Promoting Excellence in Palliative & End-of-Life Care” for $50 at the AACN LearnCenter. “The Preceptor Challenge,” a three-module course, uses virtual tools to enable nurses to identify best practices. The groundbreaking “Promoting Excellence in Palliative & End-of-Life Care” allows nurses to apply theory-based practice without the risk of harm to patients or families.

Healthy Work Environment Access AACN Healthy Work Environment Assessment, a free Web-based tool to help nurse managers and leaders align hospital unit performance with the AACN Standards for Establishing and Sustaining Healthy Work Environments (HWEs). Developed with VitalSmarts, a provider of corporate training and organizational performance products and services in Provo, Utah, the online tool aligns the performance of any clinical environment, from single hospital units to entire healthcare organizations, with the six HWE standards. They include skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership.

Access a recording of the webinar “Assessing the Health of Your Work Environment.” Available on the AACN Web site, the webinar — a joint venture between AACN and VitalSmarts, Provo, Utah — is of particular interest to users of the AACN Healthy Work Environment Assessment, a Web-based tool that aligns any clinical environment with the six HWE Standards. NOTE: Video portion of recording loads slowly.

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